There are many forms of orthoses, or devices used externally to modify the structure and/or function of the skeletal and/or neuromuscular systems of the body. For example, there are orthoses that are applied to the neck, to the spine, to the upper limbs, and to the lower limbs. Additionally, there are many different purposes for using orthoses ranging from rehabilitative, to prophylactic. Rehabilitation braces are typically used to limit the movement of the portion of the body following an injury or a surgery.
Certain rehabilitation braces, for example orthopedic knee braces, typically immobilize the leg and/or limit the motion in both the lateral and medial directions. These braces provide a mechanism to reduce the range of motion for a healing limb. The ability to limit flexion and extension are important features for an effective orthopedic knee brace. To maximize the benefits of an orthopedic brace it must be properly fitted and adjusted to the patient. Adjustment variables include fitting patients of various sizes and body proportions, and accommodating a variety of possible surgical sites. The adjustment of the brace will also be continual as the patient heals and can tolerate larger ranges of motion, as swelling is reduced, and the like. At times there may also be readjustment of the braces paddles to adapt accessories and product upgrades.
To accomplish adjustability in existing orthotic braces, some brace designs utilize a system of holes in the strut. For example, in U.S. Pat. No. 6,821,261 a series of holes incorporated into the brace's strut is disclosed. This system of holes allows support members to be adjusted into a small number of positions on the patient. The holes disclosed in the aforementioned patent slide over a button and a biasing spring forces the button into the respective hole at a particular position. The operator, or physician, must depress the button in order to advance to the next available hole. This is done repeatedly until the closest available length is achieved. One problem with this method is that the notched holes where the locking feature, or button, can engage are grossly separated along the strut, and thus, only provide for gross adjustment of the lengths of the orthopedic brace. In the case of a knee brace, there would be a need to adjust both the upper and lower lengths of the brace (as described in reference to the hinge element). Other orthopedic braces may have additional areas where the length needs to be adjusted, further compounding the gross adjustment issue.
Similarly, in U.S. Pat. No. 7,384,406 B2, a series of notches incorporated into the brace's strut is disclosed. This system of notches, just as in the previous system, allows support members to be adjusted into a small number of positions on the patient. The notches disclosed in this system are engaged by a screw with a biasing spring and a retaining bushing. The biasing spring pushes a button in an upward position. By depressing the same button, the spring pushes the retaining bushing out of a particular notch. With pressure still applied, the length of the portion of the brace is adjusted to the next available notch and the retaining bushing re-engages to lock the length. As previously described, this method only allows for gross adjustment with constant user input and thus accurate size and fit are sacrificed to the detriment of the patient.
Another existing adjustment method utilizes a cam lever and a friction lock to adjust the length of the struts. When the cam lever is unlocked the support members freely move along the struts. This system allows for a range of adjustments and sizing. However, there is no way to index the components into position and as such, accurate adjusting, or re-adjusting, of the length of the portion of the brace is difficult to accomplish.
One aspect of the present invention is an adjustable orthopedic strut system that combines a locking system with an incremental or “micro” adjustment method that is size adaptable and easy to use. One embodiment of the present invention comprises a locking system, adjustable support members, struts, and an indented molded track. The present invention improves user fitting and sizing creating better support and comfort. The present invention provides “micro” incremental adjustments on support members to allow strategic positioning of the support members near surgical incisions without the need for constant user input. Furthermore, the present invention locks and telescopes on a non-interrupted strut surface with minimal “snag” points thus reducing the difficulty in achieving fine adjustments. The system of the present invention easily indicates and indexes in a molded track and can be reduced in scale to fit many orthopedic devices to provide accurate micro-adjustments to a variety of applications and patients.